Medica Advantage Solution H8889-009 (PPO) 2026 Plan Details for Codington County, South Dakota Residents
Medica Advantage Solution H8889-009 (PPO) 2026 Plan Details for Codington County, South Dakota Residents
When selecting a Medicare Advantage plan in Codington County for 2026, it's important to compare all your options. Medica Advantage Solution H8889-009 (PPO) is among the plans you can review side-by-side with others, ensuring you find the coverage that suits your needs. You can easily enroll online or reach out to a licensed agent for personalized guidance.
Based on the most recent CMS data, plan enrollments topped 1,490 members, with 146 in Codington County, South Dakota.
Medica Advantage Solution H8889-009 Overview
| Plan ID H8889-009-0 Overview | |
|---|---|
| Health Plan ID: | H8889-009-0 |
| Medicare Advantage Plan Type: | PPO |
| Plan Year: | 2026 |
| Monthly Premium: | $0.00 Plus your Medicare Part B premium. |
| Health Plan Deductible: | $0.00 |
| Annual Out-of-Pocket Maximum: | $6750.00 (In-Network) |
| Part B Give Back: | −$100.00 reduction |
| Part D Drug Plan Benefit: | Not Included |
| Additional Benefits: | Dental, Vision, Hearing |
| Availability: | Codington County, SD |
| Insured By: | Medica |
Why Choose Medica Advantage Solution H8889-009?
This Medicare Advantage PPO plan delivers flexible access to care along with all the standard benefits of Medicare Part A and Part B. With a monthly premium of $0.00, it allows you to see any Medicare-approved provider — though you’ll typically pay less when using in-network doctors and facilities.
Primary care visits have a $0 copay | Out-of-network: $30 copay, specialist visits come with a $50 copay | Out-of-network: $65 copay, lab services cost {lab_services_cost}, urgent care services carry a $0-$45 copay, and ambulance transportation is $395 copay | Out-of-network: $395 copay. These costs count toward the plan’s annual maximum out-of-pocket (MOOP) limit of $6750.00. Once you reach that limit, in-network care is fully covered for the rest of the year.
Officially listed as CMS plan H8889-009-0. Below, you’ll find a breakdown of cost sharing for key services. Still have questions? Check the FAQ section for more information.
| We're Here to Help You Enroll |
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Out-of-Pocket Costs
Medica Advantage Solution H8889-009 includes cost-sharing, which refers to the out-of-pocket expenses you'll incur when accessing approved healthcare services. The table below outlines the most common in-network out-of-pocket costs for plan H8889-009-0.
Find out the costs for visiting your primary care doctor and specialists, as well as coverage for wellness and preventive programs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Primary: | In-network: $0 copay | Out-of-network: $30 copay |
| Specialist: | In-network: $50 copay | Out-of-network: $65 copay |
Medicare Advantage plans often include preventive and wellness benefits designed to help members stay healthy, identify risks early, and maintain an active lifestyle.
| Service | Enrollee Cost (in-network) |
|---|---|
| Annual wellness exam: | In-network: $0 copay |
| Telehealth benefit: | In-network: $0-$50 copay |
| Routine chiropractic: | Not covered |
| Fitness benefits: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Health education: | Not covered |
| Counseling services: | Not covered |
| Over the counter drug benefits: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Health transportation (non-emergency): | Not covered |
Review the costs for emergency services, urgent care, ambulance services, inpatient hospital stays, and skilled nursing facility care.
| Service | Enrollee Cost |
|---|---|
| Emergency room care: | $130 copay |
| Wordwide emergency care: | 20% coinsurance |
| Urgent care: | $0-$45 copay |
| Inpatient hospital care: | In-network: | Tier 1 | $405 per day for days 1-6 | $0 per day for days 7-90 | $0 per stay | Out-of-network: | $455 per day for days 1-6 | $0 per day for days 7-90 | $0 per stay |
| Skilled Nursing Facility: | In-network: | Tier 1 | $0 per day for days 1-20 | $218 per day for days 21-52 | $0 per day for days 53-100 | Out-of-network: | $100 per day for days 1-20 | $218 per day for days 21-43 | $0 per day for days 44-100 | $0 per stay |
| Ground ambulance: | In-network: $395 copay | Out-of-network: $395 copay |
This section explains the costs for mental health services, including individual and group therapy, and inpatient care.
| Service | Enrollee Cost (in-network) |
|---|---|
| Outpatient individual therapy: | In-network: $40 copay | Out-of-network: $55 copay |
| Outpatient group therapy: | In-network: $30 copay | Out-of-network: $55 copay |
| Inpatient psychiatric hospital care: | In-network: | Tier 1 | $405 per day for days 1-6 | $0 per day for days 7-90 | $0 per stay | Out-of-network: | $455 per day for days 1-6 | $0 per day for days 7-90 | $0 per stay |
See the cost details for rehabilitation services, including physical therapy, speech therapy, and occupational therapy.
| Service | Enrollee Cost (in-network) |
|---|---|
| Physical therapy and speech and language therapy: | In-network: $50 copay | Out-of-network: $65 copay |
| Occupational therapy: | In-network: $50 copay | Out-of-network: $65 copay |
Learn about the costs associated with medical equipment and supplies, including diabetes supplies, durable medical equipment, and prosthetics.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diabetes supplies: | In-network: 0%-20% coinsurance | Out-of-network: 0%-20% coinsurance |
| Durable medical equipment: | In-network: 0%-20% coinsurance | Out-of-network: 0%-30% coinsurance |
| Prosthetics: | In-network: 20% coinsurance | Out-of-network: 20% coinsurance |
This section outlines the costs for diagnostic services, lab tests, x-rays, and other imaging services.
| Service | Enrollee Cost (in-network) |
|---|---|
| Diagnostic radiology services: | In-network: $0-$90 copay | Out-of-network: $0-$90 copay |
| Lab services: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Outpatient x-rays: | In-network: $25 copay | Out-of-network: $25 copay |
| Diagnostic tests and procedures: | In-network: $0-$90 copay | Out-of-network: $0-$90 copay |
Review the cost-sharing details for chemotherapy and other Medicare Part B-covered drugs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Chemotherapy: | In-network: 0%-20% coinsurance | Out-of-network: 0%-30% coinsurance |
| Other Part B drugs (Medicare-covered): | In-network: 0%-20% coinsurance | Out-of-network: 0%-30% coinsurance |
This section details the dental services covered under your plan including Medicare-covered preventive dental, oral exams, x-rays, dental cleanings, and comprehensive dental.
| Service | Member Cost (in-network) |
|---|---|
| Oral exam: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Dental x-rays: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Cleaning: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Periodontics: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Endodontics: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Restorative services: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Implant services: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Orthodontics: | Not covered |
| Oral/Maxillofacial surgery: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
This section outlines the coverage for hearing-related services, including exams, fittings, and hearing aids.
| Service | Member Cost (in-network) |
|---|---|
| Hearing exam: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Fitting/evaluation: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Prescription hearing aids: | In-network: $549-$1299 copay | Out-of-network: $549-$1299 copay |
| OTC hearing aids: | In-network: $499.5 copay | Out-of-network: $499.5 copay |
Learn about the costs for vision-related services, including eye exams, eyeglasses, and contact lenses.
| Service | Member Cost (in-network) |
|---|---|
| Routine eye exam: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Contact lenses: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Eyeglass frames only: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Eyeglass lenses only: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Eyeglasses (frames & lenses): | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
| Upgrades: | In-network: $0 copay | Out-of-network: $0 copay, 0% coinsurance |
Medicare Advantage plans may include extra benefits and special needs services designed to support members with chronic conditions, mobility limitations, or other complex health needs.
| Service | Enrollee Cost (in-network) |
|---|---|
| Adult day health services: | Not covered |
| Home based palliative care: | Not covered |
| Personal emergency response system: | Not covered |
| Weight management programs: | Not covered |
| 'Wigs for chemotherapy hair loss: | Not covered |
| Alternative therapies: | Not covered |
| Massage therapy: | Not covered |
| Home/bathroom safety devices: | Not covered |
Certain preventive services are covered 100% by Medica Advantage Solution H8889-009 as a Part B benefit.
Part D Prescription Drug Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Rating Overview
The Centers for Medicare & Medicaid Services (CMS) reviews and rates Medicare Advantage (Part C) and drug plans (Part D) annually, using a 5-star system to measure aspects such as member satisfaction, preventive services, and management of chronic conditions.
Higher star ratings generally indicate better plan performance, which can be a useful factor to consider when deciding on a plan that aligns with your healthcare goals and preferences.
| CMS Measure | Star Rating |
|---|---|
| 2026 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
If you are new to Medicare or Medicare Advantage plans, the following information will help you understand the enrollment process and restrictions.
Who Can Enroll in Medica Advantage Solution H8889-009?
To qualify for enrollment in Medica Advantage Solution H8889-009, you must:
- Be entitled to Medicare Part A and enrolled in Medicare Part B.
- Live within the plan’s designated service area.
If you fulfill these criteria, you can enroll in Medica Advantage Solution H8889-009 and enjoy the extensive healthcare benefits it offers.
When Can I Enroll in Medica Advantage Solution H8889-009?
Understanding the right time to enroll in Medica Advantage Solution H8889-009 is crucial. Here are the key enrollment periods:
- Initial Enrollment Period (IEP): Your first opportunity to enroll in Medicare starts three months before your 65th birthday and lasts until three months after your birthday month.
- Annual Enrollment Period (AEP): Occurring annually from October 15 to December 7, the AEP allows you to enroll in, switch, or drop a Medicare Advantage plan if you are currently enrolled in a Medicare Advantage plan.
- Medicare Advantage Open Enrollment Period (MA OEP): From January 1 to March 31 each year, the MA OEP gives you the chance to switch Medicare Advantage plans or return to Original Medicare.
- Special Enrollment Periods (SEPs): Certain life changes, like moving or losing other coverage, may make you eligible for a SEP, allowing you to adjust your plan outside the usual periods.
Not sure when to enroll? Call HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711) to speak with a licensed insurance agent who can guide you through your options.
How to Enroll in Medica Advantage Solution H8889-009
Joining Medica Advantage Solution H8889-009 is straightforward. Here are the steps you can take:
- Online: Use our online enrollment partner's Secure Online Enrollment Form to sign up.
- By Phone: Reach out to HealthCompare (our trusted enrollment partner) at 1-833-748-3201 (TTY 711). A licensed insurance agent will help you with the enrollment process and answer any questions you might have.
- Through Medicare.gov: Enroll directly through the official Medicare website. Visit Medicare.gov, log in or create an account, and follow the steps to join Medica Advantage Solution H8889-009.
- Direct Enrollment: You can also choose to enroll directly with Medica Advantage Solution H8889-009. The contact information can be found below in the "Contact" section.
Make sure you enroll during the appropriate period to activate your coverage as soon as possible.
Here are some of the most frequently asked questions people have about plan ID H8889-009-0:
What’s the monthly premium for Medica Advantage Solution H8889-009 (PPO)?
The 2026 premium is $0.00 each month, and you must continue to pay your Part B premium.
What is the annual out-of-pocket maximum on this plan?
For 2026, the maximum you’d spend out-of-pocket in-network is $6750.00.
Is this a 4-star or 5-star plan?
CMS rates it ★3.5 out of 5 stars for 2026.
How many people are enrolled in this plan?
CMS reports 1,490 members in the latest file.
Contact Medica
| Contact Type | Details |
|---|---|
| Website: | Medica Plan Page |
| New Members: | 1-800-906-5432 |
| Existing Members: | 1-866-269-6804 |
| Plan Address: | 401 Carlson Parkway | CP 320 | Minnetonka, MN 55305 |
If you're eligible for Medicare but haven't enrolled or need to verify your enrollment status, visit the Social Security Administration website. For more information about Medicare Advantage, visit medicare.gov.
- CMS.gov, Landscape Source Files — Last accessed September 26, 2025
- CMS.gov, Medicare Part C & D Performance — Last accessed October 10, 2025
- CMS.gov, Plan Benefits Package — Last accessed October 14, 2025
- CMS.gov, Monthly Enrollment by Contract/Plan/State/County — Last accessed October 13, 2025
Learn more about how we use CMS data.
- Medica, http://medica.com — Last accessed October 13, 2025
- Medicare.gov, "Compare types of Medicare Advantage Plans" — Last accessed 25 May, 2025
- Medicare.gov, "Joining a plan" — Last accessed 25 May, 2025
- Medicare.gov, "Your coverage options" — Last accessed 25 May, 2025
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Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content managed by David Bynon, Medicare Analyst.
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